Provider Demographics
NPI:1487648747
Name:CROMWELL, DENNIS PATRICK (DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:PATRICK
Last Name:CROMWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-5410
Mailing Address - Country:US
Mailing Address - Phone:913-281-4778
Mailing Address - Fax:913-281-2703
Practice Address - Street 1:1216 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5410
Practice Address - Country:US
Practice Address - Phone:913-281-4778
Practice Address - Fax:913-281-2703
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC3430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004117Medicare ID - Type Unspecified